Concomitant Depression Research Articles

Abstract 4118183: Anxiety disorder, depression and coronary artery disease: associations and modification by genetic susceptibility

Background: Associations of anxiety disorder and depression with coronary artery disease (CAD) are heterogeneous between populations. Research questions: How does genetic susceptibility to CAD alter the associations between anxiety and depression and incident CAD? Aims: To investigate how genetic susceptibility to CAD alters the associations of anxiety and depression with incident CAD, comparing and combining anxiety and depression. Methods: This is a prospective cohort study using UK Biobank. Diagnoses of anxiety disorder and depression before the baseline assessment were ascertained through linked hospital admission data. Incident CAD was ascertained through hospital admission and death certificate data after baseline. CAD polygenic risk score (PRS) was obtained from CARDIoGRAMplus4 and categorised into low, intermediate, and high. Cox proportional hazard models were used to examine associations between anxiety and depression and CAD. The product term of PRS and these mental health conditions, and the relative excess risk due to interaction (RERI), were used to investigate the presence of multiplicative and additive interactions, respectively. Results: Our study included 288,152 participants of whom 54.4% were female, with a mean age of 56.4 years. Both anxiety disorder (HR: 2.24, 95% CI: 1.86–2.70) and depression (HR: 2.04, 95% CI: 1.80–2.32) were associated with CAD after adjusting for sociodemographic confounders. There was an addictive interaction between depression and PRS (RERI: 0.86; 95% CI: 0.06–1.65) such that the association between depression and CAD was strongest among those with a high PRS whilst there was no such evidence for anxiety disorder. Anxiety only (HR 1.69, 95% 1.17–2.45), depression only (HR 2.01, 95% CI 1.62–2.49) and concomitant anxiety and depression (HR 3.51, 95% CI 2.26–5.45) were associated with CAD even among people with a low PRS. Lifestyle mediators attenuated all these associations across PRS categories. Conclusions: CAD genetic susceptibility might partly contribute to the clustering of depression and CAD but does not provide a full explanation, nor does it explain the association between anxiety disorder and CAD. Therefore, other mechanisms should be explored.

Interoceptive disturbances in patients with functional movement disorders

Abstract. Functional movement disorders (FMD) are frequently encountered in the clinical practice of a neurologist. They are on the border of neurology and psychiatry, but the pathogenesis of the disease is still an open question. One of the causes of FMD development is considered to be interoception disorder.Objective. The aim of this study was to investigate interoceptive awareness in patients with FMD and its relationship with the severity of motor, affective, and other somatic disorders and quality of life.Material and methods. The study included 34 patients with FMD and 31 healthy volunteers, in whom interoceptive awareness was assessed using the MAIA-R scale, quality of life (SF-36), concomitant somatic symptoms (PHQ-15), and affective symptoms (HADS). The severity of FMD was assessed using the PMDRS scale. Results. The findings revealed that patients with FMD exhibit less trust in the sensations of their own bodies and tend to focus primarily on discomfort sensations. Patients with FMD also showed greater expression of concomitant somatic symptoms, anxiety, and depression. Quality of life was reduced due to the physical component of health.Conclusion. Interoceptive awareness is related to patients’ emotional characteristics and is not associated with the severity of motor impairment. The results demonstrate changes in the processing of an interoceptive information.

Trends in Anxiety and Depression Among Individuals With Rheumatoid Arthritis: A Population-Based Study.

To investigate trends in depression and anxiety over 3 decades among individuals with rheumatoid arthritis (RA). Patients with incident RA (age ≥ 18 years, meeting 1987 American College of Rheumatology criteria between 1985 and 2014) were identified using the Rochester Epidemiology Project. Individuals with RA were matched 1:1 with non-RA comparators on age, sex, and calendar year of RA incidence. Patients were followed until death, migration, or December 31, 2020. Depression and anxiety were defined using established International Classification of Diseases, 9th and 10th revision code sets. Cox models were used to compare trends in the occurrence of depression and anxiety diagnoses and cooccurring anxiety and depression by decade and RA status, adjusted for potential confounders. The study included 1012 individuals with RA and 1012 matched controls (mean age 55.9 years, 68.38% female). Hazard ratios (HRs) demonstrated a temporal increase in anxiety and cooccurring anxiety and depression from 2005-2014 compared to 1985-1994 for individuals both with and without RA. Persons with RA exhibited a rising occurrence of anxiety (HR 1.27, 95% CI 0.86-1.88) and concomitant anxiety and depression (HR 1.49, 95% CI 0.96-2.33) compared to controls. Trends were most pronounced in seropositive patients with RA (anxiety: HR 4.01, 95% CI 2.21-7.30). Anxiety and concomitant anxiety and depression diagnoses are elevated in individuals with RA. The increasing occurrence of anxiety and cooccurring anxiety and depression suggests rising awareness and diagnosis of these disorders. Adding to stable but high rates of depression diagnoses, individuals with RA now have evidence of a widening gap in mental health diagnoses that clinicians should address.

Neuropharmacological Assessment of Sulfonamide Derivatives of Para-Aminobenzoic Acid through In Vivo and In Silico Approaches

Background/Objectives: Alzheimer’s disease (AD), a complex neurogenerative disorder, manifests as dementia and concomitant neuropsychiatric symptoms, including apathy, depression, and circadian disruption. The pathology involves a profound degeneration of the hippocampus and cerebral cortex, leading to the impairment of both short-term and long-term memory. The cholinergic hypothesis is among the various theories proposed, that assume the loss of the cholinergic tract contributes to the onset of AD and proves clinically effective in managing mild to moderate stages of the disease. This study explores the potential therapeutic efficacy of sulfonamide-based butyrylcholinesterase inhibitors in mitigating scopolamine-induced amnesia in rats. Methods: Behavioral assessments utilizing Y-maze, Barnes maze, and neurochemical assays were conducted to evaluate the effectiveness of the test compounds. Results: Results demonstrated a significant reduction in the impact of scopolamine administration on behavioral tasks at a dose of 20 mg/kg for both compounds. Correspondingly, neurochemical assays corroborated these findings. In silico docking analysis on rat butyrylcholinesterase (BChE) was performed to elucidate the binding mode of the compounds. Subsequent molecular dynamics studies unveiled the formation of stable complexes between the test compounds and rat BChE. Conclusions: These findings contribute valuable insights into the potential therapeutic role of sulfonamide-based butyrylcholinesterase inhibitors in addressing memory deficits associated with AD, emphasizing their in silico molecular interactions and stability.

7440 Both GLP-1RA and SGLT2i medications are associated with lower depression scores in veterans compared to metformin and insulin

Abstract Disclosure: S.D. Ubalde: None. H. Cann: None. L. Esper: None. J. Powell: None. K. Meyer: None. S. Sen: None. Background: Type 2 diabetes (T2DM) and depression are considered bidirectional. Depression and mental health issues are often co-morbidities and present with management challenges in veterans with T2DM. With the advent of novel meds for T2DM, it is important to choose appropriate T2DM medication in this context.Glucagon-like-peptide-1 receptor agonists (GLP-1RA) act on the hypothalamus to reduce weight and glycemic indices in T2DM patients which may play a positive role on the amygdala and help improve mood and depression. We hypothesized that patients taking the GLP1-RA (+/-insulin) regimen would have lower PHQ-9 depression scores compared to patients taking SGLT2i (+/-insulin), metformin (+/- insulin), or insulin (ins) alone. Methods: We conducted a retrospective chart review of patients from the Diabetes Clinic at VA Med Center over 10 months to find an association between PHQ9 depression scores and anti-diabetic regimen. We reviewed 200 patient charts and decided to analyze 88 subjects that had bonafide depression that is PHQ-9 score of at least 5 or above including mild, moderate, and severe depression as per the PHQ9 scoring system. Results: Our cohort had a mean age of 64.16±1.18 years. All patients were either overweight or had obesity (BMI 25-45). Percentage prescriptions of different diabetes medications show that most patients are on insulin alone with 35 patients (39.77%), while Metformin (+/- ins) had 23 (26.14%), GLP-1RA (+/- ins) had 17 (19.32%), and with the lowest use in SGLT2i (+/- ins) had 13 (14.77%). The mean BMI was 32.29±0.80, which was similar across the groups with the SGLT2i (+/- ins) group having a slightly lower BMI of 27.80±1.28. Mean A1C was 8.0±0.2 with no difference found between groups. Comparing depression scores between all groups the Brown-Forsythe ANOVA test analysis showed significance of p = 0.0383 among all groups. Contrary to our hypothesis, both GLP-1RA and SGLT2i groups (rather than GLP1RA alone) had a significantly lower mean PHQ-9 score of 8.824±0.81(p = 0.0486, using unpaired t-test) and 8.077±0.91 (p = 0.0311) respectively, compared to the metformin group with a score of 12.04±1.2. Insulin-only group score was slightly lower than metformin at 11.03±0.95, and there was no statistical difference when compared to other groups. Conclusion: In a real-life setting of T2DM clinic subjects that were overweight or obese, depression scores were lower in patients taking the GLP1RA and SGLT2i. This effect was independent of differences in BMI or A1C metrics between the groups. The majority of T2DM veteran patients were prescribed insulin alone indicating under-utilization of novel T2DM meds such as SGLT2i and GLP1A agents. Continuing this research, particularly in a VAMC cohort, may provide insight into the choice of appropriate T2DM medications that may help veterans with concomitant T2DM and depression. Presentation: 6/2/2024

The Psychosocial Burden Of Psoriasis: Understanding The Impact On Mental Health And Well-Being

Psoriasis is a chronic, systemic inflammatory skin condition that is distinguished by scaly, red lesions that can be uncomfortable, itchy, and disfiguring. Psoriasis can influence aspects of one’s life beyond distressful physical symptoms, such as mood and quality of life. Patients diagnosed with psoriasis are 39% more likely to suffer from concomitant depression and 31% of patients are diagnosed with anxiety [1]. Due to physical manifestations, individuals with psoriasis are at increased risk of developing issues of poor social perception and body image stress [2]. Research states that psoriasis flare-ups are sometimes directly linked with bouts of anxiety and depression; conversely, physical symptoms of psoriasis may be attributed to psychosocial issues. For example, depression may cause a lack of proper adherence to treatment and lead to exacerbated inflammation. Understanding the psychosocial aspects of psoriasis may provide pertinent clinical information; thereby, allowing seamless integration of psychiatric treatments for the overall treatment protocol for psoriasis. This project delves into understanding how decreased emotional and social well-being can challenge the proper maintenance and treatment of psoriasis. Further, this paper highlights adaptive coping strategies and social support networks that are key in enhancing treatment viability. Oliver C, Robert PD, Daihung D, et al. The Risk of Depression, Anxiety, and Suicidality in Patients With Psoriasis. Arch Dermatol. 2010;146(8) Hepat A, Chakole S, Rannaware A. Psychological Well-Being of Adult Psoriasis Patients: A Narrative Review. Cureus. 2023

Research on the soothing Liver - Qi stagnation method in the treatment of postoperative papillary thyroid carcinoma patients' concomitant depression: A randomized controlled clinical trial.

Postoperative papillary thyroid carcinoma (P-PTC) patients often grapple with depression fueled by the looming threat of recurrence. While the Liver-Qi stagnation method is frequently employed for depression management, a notable scarcity of clinical trials exists regarding its application in patients with P-PTC and concurrent depression. This study presents a randomized controlled clinical trial, aiming to establish the efficacy of the Liver-Qi stagnation method in alleviating depression in patients with P-PTC. In this randomized controlled clinical trial, P-PTC patients diagnosed with concomitant depression were systematically enrolled. Subjects were randomly assigned to either the control or test group, both receiving standard treatment comprising Levothyroxine sodium tablets and decoction of benefiting Qi and nourishing Yin. Additionally, the test group received supplementation with bupleuri radix-paeoniae alba radix (CH-BS) alongside the baseline therapy. The intervention spanned 12 weeks. Pre- and post-treatment evaluations were conducted using the Hamilton Depression Scale (HAMD), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Traditional Chinese Medicine (TCM) syndrome score scale. Concurrently, blood inflammatory factors and serum 5-hydroxytryptamine (5-HT) levels were measured to comprehensively assess treatment outcomes. During the 12-week intervention, the test group demonstrated a significant reduction in HAMD scores compared to the control group (P < .05). Moreover, post-treatment serum 5-HT levels were significantly elevated in the test group compared to the control group (P < .05). Findings gleaned from the EORTC QLQ - C30 revealed a noteworthy improvement in social function and overall quality of life scores within both groups post-treatment in comparison to baseline (P < .05). Concurrently, post-treatment scores for fatigue and insomnia symptoms witnessed a significant decrease compared to baseline (P < .05). Notably, the test group exhibited superior scores in the emotional domain in contrast to the control group (P < .05). Both groups exhibited a substantial decrease in TCM syndrome scores from baseline (P < .05). Noteworthy increases were found in IFN-γ < 2.44 rate (62.86%) and IL-6 < 2.44 rate (74.29%) in the test group compared to pretreatment levels (P < .05). The soothing Liver-Qi stagnation method induces a rise in serum 5-HT levels, reducing depression-related inflammatory factors, culminating in the alleviation of depression for P-PTC.

Multipsychiatric Comorbidity in People With Epilepsy Compared With People Without Epilepsy: A Systematic Review and Meta-analysis.

Persons with epilepsy (PwE) have a higher risk of developing psychiatric comorbidities compared with the general population. There is limited knowledge about the prevalence of multiple psychiatric conditions in PwE. We summarize the current evidence on the prevalence of multipsychiatric comorbidities in PwE compared with persons without epilepsy. A systematic review of multipsychiatric comorbidities in PwE compared with persons without epilepsy was performed, and the results were reported using the Preferred Reporting Items of Systematic Reviews and Meta-analyses reporting standards. The search was conducted from January 1945 to June 2023 in Ovid MEDLINE. Embase, and PsycINFO, using the search terms related to "epilepsy," "psychiatric comorbidity," and "multimorbidity," combined with psychiatric disorders. Abstracts were reviewed in duplicate, and data were independently extracted using standard proforma. Data describing multipsychiatric comorbidities in PwE compared with persons without epilepsy were recorded. Descriptive statistics and, when feasible, meta-analyses are presented. The risk of bias of the studies was assessed using the Newcastle-Ottawa Scale and the International League Against Epilepsy tool. A total of 12,841 records were identified from the systematic database search, and 15 studies met the eligibility criteria. All included studies were deemed high-quality in risk of bias according to both tools. The prevalence of multipsychiatric comorbidity was greater in persons with compared with those without epilepsy. The pooled prevalence of concomitant depression and anxiety disorder in PwE in 2 population-based studies was 15 of 163 (9.2%), which was significantly higher than 250 of 10,551 (2.4%) in patients without epilepsy (odds ratio [OR] 3.7, 95% CI 2.1-6.5, p-value <0.001, I2 = 0%, Cochran Q p-value for heterogeneity = 0.84). In 2 hospital-based studies, the prevalence of concomitant depression and attention-deficit/hyperactivity disorder in PwE (14/97, 14.4%) was significantly higher than in patients without epilepsy (5/126, 3.9%), with an OR 5.2 (95% CI 1.8-15.0, p-value = 0.002, I2 = 0%, Cochran Q p-value for heterogeneity = 0.79). PwE experience elevated levels of multipsychiatric comorbidity compared with those without epilepsy. However, very few studies have empirically evaluated the extent of multipsychiatric comorbidity in PwE compared with persons without epilepsy nor their associations and consequences to prognosis in PwE.

Molecular mechanism of basolateral amygdala involved in electroacupuncture-induced amelioration of cancer pain and concomitant depression based on transcriptomics techniques.

To observe the effect of electroacupuncture (EA) of "Zusanli" (ST36) and "Sanyinjiao" (SP6) on cancer pain and concomitant negative emotion in cancer pain model mice, and to explore its molecular mechanisms in the basolateral amygdala (BLA) by using transcriptomics techniques. C57BL/6 mice were randomized into sham operation, model and EA groups, with 10 mice in each group. The cancer pain model was established by injecting PBS suspension containing Lewis lung cancer cells into the femur. The mice in the EA group received EA stimulation(1 mA, 2 Hz) on ST36 and SP6 from the 10th day after modeling, 20 min per day for 12 successive days. The bone damage of the distal femur was observed with X-ray and H.E. staining, respectively. The mechanical pain threshold (MPT) was detected by using von Frey. The depression-like behavior was detected by using sucrose-preference test (sucrose preference index in 12 h), and the immobility (feeling of despair) duration of forced swimming within 4 min. The BLA tissue was extracted for RNA sequencing (RNA library construction, and screening differential gene profiling by transcriptomic sequencing) and bioinformatics analysis. The real-time PCR was used to validate the mRNA expression of differentially expressed genes：tumor necrosis factor superfamily 8 (Tnfsf8), bone marrow stromal cell antigen 1 (Bst1), prodynorphin (Pdyn) and voltage-gated sodium channelβ4 (Scn4b). H.E. staining and X-ray showed significant bone damage in the distal femur in cancer pain mice. In contrast to the sham operation group, the MPT on the 1st , 4th, 7th , 10th, 14th and 21st day after modeling and sucrose preference index were significantly decreased (P<0.001, P<0.000 1), and the immobility time of the forced swimming was considerably increased in the model group (P<0.001). In contrast to the model group, the MPT values on the 14th and 21st day and sucrose preference index were obviously increased (P<0.000 1, P<0.05), and the immobility time was strikingly decreased in the EA group (P<0.01). RNA sequencing showed that a total of 404 differentially expressed genes (205 up-regulated, 199 down-regulated) were screened in the model group compared with the sham operation group, and a total of 329 differentially expressed genes (206 up-regulated and 123 down-regulated) were screened in the EA group compared with the model group. Venn diagram analysis of the differentially expressed genes showed that 45 up-regulated and 28 down-regulated genes in the model group were completely reversed by EA. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the screened differentially expressed genes revealed that the above differential genes were mainly enriched in the ligand receptor activity, cytokine receptor binding, and cytokine activity related to neuro-inflammation, as well as in neuropeptide signaling pathways related to neuronal excitability, and calcium ion mediated signal transduction. The analysis of KEGG pathway showed that the differentially expressed genes were mainly enriched in the inflammation-related pathways, such as interleukin-17 pathway. Validation analysis of the differentially expressed genes showed that the expression levels of Tnfsf8 and Bst1 were significantly up-regulated in the model group compared with the sham operation group (P<0.01, P<0.05), and down-regulated by EA (P<0.01, P<0.05), while the expression levels of Pdyn and Scn4b were down-regulated in the model group in comparison with the sham operation group (P<0.01), and up-regulated by EA (P<0.05, P<0.01), which was consistent with the changing trend of the gene sequencing results. Acupuncture of ST36 and SP6 can significantly relieve cancer pain and concomitant negative emotion in cancer pain mice, which may be related to its functions in alleviating neuro-inflammation and relieving the abnormal activities of specific neurons in the BLA.

Advances in attenuating opioid-induced respiratory depression: A narrative review.

Opioids exert analgesic effects by agonizing opioid receptors and activating signaling pathways coupled to receptors such as G-protein and/or β-arrestin. Concomitant respiratory depression (RD) is a common clinical problem, and improvement of RD is usually achieved with specific antagonists such as naloxone; however, naloxone antagonizes opioid analgesia and may produce more unknown adverse effects. In recent years, researchers have used various methods to isolate opioid receptor-mediated analgesia and RD, with the aim of preserving opioid analgesia while attenuating RD. At present, the focus is mainly on the development of new opioids with weak respiratory inhibition or the use of non-opioid drugs to stimulate breathing. This review reports recent advances in novel opioid agents, such as mixed opioid receptor agonists, peripheral selective opioid receptor agonists, opioid receptor splice variant agonists, biased opioid receptor agonists, and allosteric modulators of opioid receptors, as well as in non-opioid agents, such as AMPA receptor modulators, 5-hydroxytryptamine receptor agonists, phosphodiesterase-4 inhibitors, and nicotinic acetylcholine receptor agonists.

Serotonin blood level study, anxiety-depressive states indicators and patients life quality after laparoscopic treatment of gastroesophageal reflux disease

Nowadays effective treatment of gastroesophageal reflux disease (GERD) remains a difficult and still unsolved problem. The use of various antisecretory drugs in combination with surgical treatment does not allow to achieve a long lasting improvement of the quality of life and reliable prevention of complications. In this regard, special attention is paid to study humoral factors influencing the pathogenesis of GERD, data on which will improve the results of therapeutic and surgical treatment. It is promising to study the dynamics of serotonin after laparoscopic treatment of various types of GERD, especially in combination with dyspepsia, anxiety or depressive disorders, as well as the possibility of using drugs that affect the metabolism of this hormone to correct the above mentioned disorders and achieve long lasting recovery after laparoscopic fundoplication. The aim of the work was to study the dynamics of serotonin in the blood during laparoscopic total fundoplication and analyze the correlation of this hormone with the psychological well-being of patients before and after surgical treatment of GERD. Materials and methods. Laparoscopic fundoplication by Short Floppy Nissen modification was performed in 35 patients with GERD. There were 26 (74.3 %) women, 9 (25.7 %) men. Age – 55.3 ± 11.3. The comparison group consisted of 20 healthy volunteers (women – 14 (70.0 %); men – 6 (30.0 %), average age – 56.7 ± 10.6), who did not undergo surgery. The groups were comparable by gender and age. The studies were carried out in venous blood plasma, samples of which were maintained using standard methods and stored in a low-temperature freezer at a temperature of -80 °C. Tests for serotonin (Serotonin ELISA, RE59121, IBL) were studied on the immunoenzyme complex ImmunoChem-2100 (USA) of the Department of Clinical Laboratory Diagnostics in the Zaporizhzhia State Medical and Pharmaceutical University. The concentration of the last indicators was expressed in ng/ml. The presence of concomitant anxiety, depression and level of psychological well-being was assessed using the GAD-7, PHQ-9 and SF-36 questionnaires. Statistical assessment of the research results was carried out using the Statistica for Windows 13 software package (StatSoft Inc., No. JPZ804I382130ARCN10-J). Differences were considered statistically significant at p &lt; 0.05. Results. The serotonin level in the blood of practically healthy people was 5.8 ± 1.5 ng/ml. In the main group serotonin values before surgical treatment were 3.1 ± 1.3 ng/ml. After surgical treatment the serotonin level increased to 5.4 ± 1.8 ng/ml and was not statistically different from the level of practically healthy patients. The dynamics of serotonin levels correspond to the dynamics of the patients number with signs of anxiety and depression before and after surgery in the main group, as well as the improvement in the psychological state of patients after surgery compared to preoperative data on the scales of the “psychological component” of SF-36 health questionnaire: Vitality (VT), Social Functioning (SF), Role-Emotional (RE), Mental Health (MH). Conclusions. Laparoscopic crurorrhaphy and fundoplication in the Short Floppy Nissen modification through the mechanism of serotonin helps to improve the psychological state of patients with GERD in the postoperative period, eliminate anxiety and depression, improve quality of life and achieve a lasting antireflux effect. The obtained dynamics of serotonin levels confirms its participation in the formation of behavioral reactions in GERD, helping to improve the results of surgical treatment.

Managing the Dual Diagnosis Dilemma of Bipolar Disorder and Substance Abuse in Clinical Settings

Objective: Drug addiction is a chronic mental disorder that significantly impacts all aspects of an individual’s life, and substance use disorder in patients with bipolar disorder. The objective of this study is to assess the frequency of substance abuse among patients with bipolar spectrum disorder. Method: This cross-sectional study evaluated the frequency of bipolar spectrum disorder in patients taking methadone through various screening measures, including Mini Mental State Examination (MMSE), DSM IV criteria, Mood Disorders Questionnaire (MDQ), Goodwin and Ghaemi’s criteria, and Akiskal classification for bipolar disorders. Results: Out of the total 197 participants in the study, 77 were identified as individuals engaging in poly-substance abuse. The investigation assessed the frequency of bipolar spectrum disorder based on various diagnostic criteria: 24% according to DSM-IV criteria, 29.9% using MDQ, 29.9% based on Ghaemi and Goodwin’s criteria, and the highest rate at 48.2% when applying Akiskal’s classification. Conclusions: This study highlights the high frequency of bipolar disorder among individuals with substance use disorder, especially those with concomitant depression. Therefore, it is crucial to pay special attention to individuals with substance use disorder with co-existing bipolar disorder.

Effects of citalopram on blood pressure control in depressive patients with hypertension: A randomized clinical trial.

Since there is a bi-directional interaction between hypertension and depression, we aimed to evaluate the effects of citalopram administration in the management of hypertension. A randomized clinical trial was conducted on 72 patients with concomitant depression and hypertension. The intervention group (n=41) received citalopram 20 mg daily plus anti-hypertensive standard treatment, while the control group (n=31) received only the standard treatment. The study's primary endpoint was in-office blood pressure (BP) measurement at baseline and home BP monitoring in the first and second months after entering the study. There were no significant differences in baseline systolic BP (163.3±19.6 vs.164.2±20.3 mm Hg; P=0.910) and diastolic BP (94.5±13.8 vs. 88.2±14.4; P=0.071). After one month, diastolic BP (82.7±11.7 vs. 77.09±12.2; P=0.023) was significantly higher in the control group compared to the intervention group. Two months after the intervention, systolic BP (133.8±16.5 vs. 124.5±12.4; P=0.009) and diastolic BP (80.7±10.3 vs. 73.7±9.7; P=0.002) were significantly decreased in the intervention group compared to the control group. This study supported the beneficial effects of citalopram in lowering BP in patients with concomitant depression and hypertension.

Prevalence and predictors of depression and anxiety in patients with chronic rhinosinusitis: a systematic review and meta-analysis

BackgroundChronic rhinosinusitis (CRS) is a persistent inflammation of the sinuses. As a result of long-term discomfort, patients may experience symptoms of common mental disorders such as anxiety and depression. This...

A novel small deletion in the ATP2A2 gene in a patient with sporadic Darier’s disease and concomitant depression: a case report

A novel small deletion in the ATP2A2 gene in a patient with sporadic Darier’s disease and concomitant depression: a case report

Fear of falling and associated factors in older adults with heart failure.

This study aimed to evaluate the prevalence of fear of falling and associated factors in older adults with heart failure. A prospective, cross-sectional study. The study included 100 geriatric patients who were hospitalised and treated in the cardiology department of our hospital with ventricular ejection fraction (LVEF) lower than 50% for at least 1 year. A series of geriatric assessments were performed by face-to-face interview on the day of admission. Electrocardiography (ECG) and transthoracic echocardiography (TTE) were also performed on the day of admission. The median age of the patients was 72 years, and 72.0% were men. Falls Efficacy Scale scores indicated a fear of falling in 46 (46.0%) of the patients. Charlson Comorbidity Index (CCI) was significantly higher in patients with fear of falling (P < 0.001). Severe depression, severe clinical insomnia, daytime sleepiness, and malnutrition were significantly more frequent among patients with fear of falling. Fear of falling was associated with significantly lower LVEF (P = 0.001). The presence of severe depression increased the risk of fear of falling by 13.97 times (95% CI: 3.064-63.707; P = 0.001), and the presence of daytime sleepiness increased the risk by 3.49 times (95% CI: 1.012-12.037; P = 0.048). A one-unit increase in CCI increased the risk of fear of falling by 1.56 times (95% CI: 1.093-2.238; P = 0.014). Heart failure patients with concomitant depression, sleep disorders, and high comorbidities have greater fear of falling.

Preschoolers’ Executive Function Development and Maternal Birth Experience: The Moderating Role of Depression and the Mode of Delivery

Early executive functioning is a crucial precursor to the future cognitive and behavioral development of children. Given that the mother is typically the child’s primary caregiver, her maternal behavior may be an important factor that either facilitates or hinders the child’s cognitive development, especially if the mother suffers from depression. It is important to analyze these effects, taking into consideration the mother’s birth experience. This study focuses on assessing the child’s executive functions, the mother’s concomitant depression and her birth experience, including the mode of delivery. The results obtained have shown no significant relationship between the executive function performance and the mother’s concomitant depression. However, significant relationships have been found between the child’s executive function performance and complications during the mother’s pregnancy, birth and mode of delivery. The regression analysis shows that cesarean birth reduces the child’s overall executive function performance by 1 point, while the data of the moderation analysis including the mode of delivery and mother’s depression are not statistically significant. The total executive performance score is largely related to the mother’s educational level. The mother’s perinatal depression may have a stronger adverse effect on the child’s development than her concomitant depression. A higher level of the mother’s education may be a protective factor that could potentially offset the cesarean birth effect.

Outcomes Among Hospitalized Patients with Acute Chest Syndrome and Concomitant Clinical Depression: A United States Population-Based Cohort Study

Background Acute chest syndrome is a life-threatening complication of sickle cell disease, seen in both children and adults. Hospitalization and immediate treatment are necessary to prevent morbidity and mortality. Clinical depression is quite prevalent in patients with sickle cell disease, and review of literature reveals association of depression with increased annual emergency department visits, hospitalizations, and blood transfusions in patients with sickle cell disease. Whether this leads to worse outcomes is yet to be ascertained. Methods We utilized the 2018-2020 National Inpatient Sample (NIS) Database in conducting a retrospective cohort study. We identified hospitalized patients with acute chest syndrome and concomitant clinical depression using appropriate ICD-10 CM codes. We stratified patients based on whether they had clinical depression during the hospitalization or not. A survey multivariable logistic and linear regression analysis was used to calculate adjusted odds ratios (OR) for the primary and secondary outcomes. A p value of &amp;lt;0.05 was considered statistically significant. The aim of this study is to investigate the outcomes among hospitalized patients with acute chest syndrome and comorbid clinical depression looking primarily at the in-hospital mortality and hospital length of stay (LOS). Results We identified a total of 5271 hospitalized patients with acute chest syndrome, of which 10.72% (565/5271) had comorbid clinical depression. The overall in-hospital mortality among those with acute chest syndrome was 3.70% (195/5271). Among those with clinical depression, the overall in-hospital mortality rate was not significantly higher at 5.31% (30/565) (p=0.385). Utilizing a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, clinical depression among hospitalized patients with acute chest syndrome did not significantly increase the risk for in-hospital mortality (adjusted OR 1.39, 95% confidence interval [CI], 0.49-3.91; p=0.533) or prolong hospital LOS (median LOS 6 days versus 7 days, p=0.631) Conclusion Acute chest syndrome continues to be an important cause of hospital admissions in patients with sickle cell disease. Our analysis revealed that clinical depression is commonly encountered in this subset of patients. Clinical depression did not have a statistically significant impact on outcomes including increased in-hospital mortality or prolonged hospital LOS. Prospective studies with large sample sizes are needed to better understand these outcomes.

A psychometric evaluation of the 16-item PHQ-ADS concomitant anxiety and depression scale in the UK biobank using item response theory

BackgroundThe Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) provides a reliable and valid measure of concomitant depression and anxiety. However, research on its psychometric efficiency and optimal scale length using item-response theory (IRT) has not been reported. This study aimed to optimize the length of the PHQ-ADS scale without losing information by discarding items that were a poor fit to the IRT model. MethodsThe UK Biobank is a large cohort study designed to investigate risk factors for a broad range of disease. PHQ-ADS data were available from n = 152,826 participants (age = 55.87 years; SD = 7.73; 56.4 % female), 30.4 % of the entire UK Biobank sample. Psychometric properties of the PHQ-ADS were investigated using a 2-parameter IRT and Mokken analysis. Item statistics included discrimination, difficulty and Loevinger H coefficients of monotonicity. ResultsIn the entire 16-item scale, item discrimination ranged from 1.40 to 4.22, with the item ‘worrying’ showing the highest level of discrimination and the item ‘sleep disturbance’ showing the lowest. Mokken analysis showed that the 16-item PHQ-ADS scale could be reduced to a 7-item scale without loss of test information. The reduced scale comprised mainly items measuring cognitive-affective symptoms of anxiety/depression, whereas items measuring somatic symptoms were discarded. The revised scale showed high discrimination and scalability. LimitationsFindings are limited by the use of cross-sectional data that only included the baseline online questionnaire, but not other waves. ConclusionsIRT is a useful technique for scale reductions which serve the clinical and epidemiological need to optimize screening questionnaires to reduce redundancy and maximize information. A reduced-item 7-item PHQ-ADS scale reduces the response burden on participants in epidemiological research settings, without loss of information.

THE PREVALENCE AND SEVERITY OF DEPRESSION AND ANXIETY IN HEART FAILURE PATIENTS IN BULGARIA

Background: Depression and anxiety are common in patients with heart failure (HF). They are associated with adverse outcomes such as reduced adherence to treatment, poor ventricular function, increased hospitalizations, and higher mortality rate. However, despite the importance of these concomitant conditions, depression and anxiety often remain underdiagnosed and undertreated in patients with HF. Aim: The aim of the study is to evaluate the prevalence and severity of depression and anxiety in patients with HF. Materials and methods: 138 patients with chronic HF, a mean age of 70.29 ± 9.73 years and male/female ratio – 63 (45.7%)/75 (54.3%) were included in this cross-sectional study. Tests for depression (Hamilton Depression Rating Scale; HAM-D) and anxiety (Hamilton Anxiety Scale; HAM-A) were performed in all participants. Results: 114 (82.6%) of the patients with HF have depression and 98 (71%) – anxiety disorder. Mild depression was found in 38 (33.3%) patients and moderate – in 49 (42.9%). Severe depression was found in 21 (18.4%) of the patients and very severe – in 6 (5.3%). In our cohort, women more often were diagnosed with depression than men (71.4% vs. 28.6%, (p&lt;0.05)). Older age above 70 years was associated with an incidence of depression (AUC 0.75, 67% sensitivity and 64% specificity, p&lt;0.05). Significant predictors of depression in HF patients were anemia (OR 2.74 (95% CI 1.23-4.56, p&lt;0.05), CKD (OR 12.29 (95% CI 1.57-16.17, P&lt;0.05), ejection fraction below 50% (OR 4.35 (95% CI 2.07-8.85, P&lt;0.05) and alcohol consumption (OR 6.39 (95% CI 1.72 – 15.14, P&lt;0.05). Mild anxiety was diagnosed in 28 (28.6%) of the patients, 52 (53.1%) were with moderate and 18 (18.4%) – with severe anxiety. Predictors of anxiety in our HF cohort were poor controlled arterial hypertension (OR 2,18 (95% CI 1.26-5.57 P&lt;0.05), alcohol consumption (OR 2,75, (95% CI 1.43-4.23, P&lt;0.05), advanced HF (OR 4.57, (95% CI 2.02-7.66, P&lt;0.05) and previous myocardial infarction (OR 3,25, (95% CI 1.89-5.53, P&lt;0.05). Conclusions: Out data shows that the key factors associated with the risk of developing depression in patients with HF are: CKD, anemia, alcohol use, ejection fraction &lt; 50, while the most important factors associated with the development of anxiety are: uncontrolled hypertension, alcohol use, advanced HF and previous MI.